مجله پزشکی قانونی
سال بیست و چهارم شماره 3 (پیاپی 87، پاییز 1397)

Every year, many people come to emergency care due to methanol poisoning and receive healthcare services. Therefore, the aim of this study was to investigate the effective factors in the prognosis of patients with acute methanol poisoning admitted to Imam Khomeini Hospital in Kermanshah during 2010-1015.
Instruments & This is a retrospective descriptive-analytic study. Sampling was done by census method. The study population included patients with acute methanol poisoning referring to Imam Khomeini Hospital in Kermanshah from 2010 to 2015. The required information including age, gender, date of referral, times interval until patient referral, clinical signs and symptoms of ECG symptoms, type of treatment and eventual poisoning from medical records and phone call with patients referring to Imam Khomeini Hospital were collected by filling in the relevant checklist. The data were analyzed by SPSS 22. Mann-Whitney test, Chi-square test or Fisher exact test, and multivariate logistic regression were used. 188 (96.5%) of the patients were male and 7 (3.5%) were female. The mortality rate of the patients was 12.5%. There was a significant relationship among mortality rate and age, clinical symptoms (including coma, blurred vision, pupil size, nausea, and vomiting), laboratory symptoms (including urea, creatinine, glucose, AST, ALT, CPK, LDH, pH, and bicarbonate), non-cardiac rhythms, prescription of ethanol, folic acid, corticosteroid and bicarbonate, and conducting, the frequency, and duration of dialysis (p<0.05). Consciousness level, creatinine level, and pH of methanol-poisoned patients when admitted to the emergency department can predict the outcome of treatment and the mortality situation.

In the North Khorasan province with a multicultural population, the conflict has appeared as a notable phenomenon. The aim of this research was to investigate the epidemiology and demography of conflict in the forensic offices of North Khorasan province, Iran.
Instruments & In this descriptive-survey research, 2258 people, who were referred to forensic offices of North Khorasan from the criminal and police courts during 4 months (May-September 2016), were investigated. In this regard, a questionnaire was designed and given to referrals. The data were analyzed, using SPSS 19 software and Chi-square test. 89.77% of conflicts were related to people with income less than 1 million Toman per month. 38.09% of conflicts occurred at home and 41.67% occurred among relatives. 83.00% of people had diplomas and lower than diploma. The most common weapon used was knife (48.16%). The frequency of conflicts in Ramadan was lower than other days. In North Khorasan province, most of the conflicts are related to people with low income and low education levels due to family issues. During Ramadan, the conflict is less than in other months and in the cold months, it occurs less than the other months. The pattern of using pre-defined tools in the conflicts is very serious and alarming. The results on the frequency of the place of conflict, the existence of a kinship relationship between the assailant and the victim, the cause of the conflict, and the marital status of the injured may indicate that family in this province is threatened with violence.

Legal medicine records are one of the main sources of information for performing legal duties and serving the service, and the most important tools for filling and retrieving information in the investigation and responding process. The results of the thoughts and measures of legal medicine organization are preserved as records and documents, which have been produced with considerable time and cost. For the creation of records information, so that they can be used quickly and easily, it is necessary to organize the data appropriately so that data filling and retrieval can be done conveniently. The aim of this study was to develop essential indicator set for organizing records of legal medicine commission of Iran.
Instruments & This study was performed by descriptive and Delphi methods in Iranian Legal Medicine Organization during 2016 and 2017. In this study, with Delphi method, the initial questionnaire was designed and 400 file of referrals to the commission of Tehran Legal Medicine Center were randomly studied and analyzed with descriptive statistics. By studying and reviewing the results of the initial questionnaire by experts and members of the Delphi panel, the indicators led to the final compilation. To organize records in 3 main parts, 27 indicators and 175 evaluation criteria were extracted and the determination of record retention period for commission were agreed upon by experts. Currently, Legal Medicine Organization faces weaknesses in organizing records of legal medicine commission. Organizational indicators improve the speed and simplicity of access to valuable information of records. Records can be legally summerized with the permission of the National Documents Council.

Considering the high rate of factitious injuries in Iran and in order to identify such injuries and providing solutions to reduce fraud in the use of insurance, this study was conducted with the aim of investigating injury patterns, personal characteristics, and traffic accident coordinates.
Instruments & This cross- sectional study was conducted from July 2016 to the end of June 2017 on factitious injuries diagnosed in the Forensic Medicine office in Hormozgan province. A checklist containing demographic variables and the type and location of injuries were used to collect the data. The criminal records of individuals were investigated by Police Criminal Investigation Department of Hormozgan Province. The data was analyzed in Stata 12, using Chi-square. Out of 58 cases of factitious injuries, 57 cases were male (98.3%) and most cases (51.7%) were from the age group of 20 to 30 years. Most individuals were self- employed (72.4%) and had the level of education below the diploma (65.5%). The most common site of superficial injury was the forearm (60.3%), the most common site of fracture was Distal Ulna (25.9%), and the most common manifestation of factitious injury was abrasion. The most cases with factitious injuries were male in the age group 20 to 30 years, self- employed, and with elementary of education and criminal record. With regard to the pattern of injuries, the most common site of superficial injury and fracture are forearm and Distal Ulna, respectively, and the most common manifestation of factitious injury is abrasion.

World Health Organization has codified the guidelines for correct filling of death certificates, choosing the cause of death, and documenting it according to ICD10 codes. In this study, the coordination of the causes of death recorded on death certificates issued at Sanandaj Hospitals was, evaluated using ICD_10 criteria.
Instruments & In this descriptive-analytical study, 1506 death certificates were extracted during July 2015 to September 2017 form Tohid and Besat Hospital archives and information including age, gender, season, attending physician, the physician who issued the certificate, the admitting ward, and ICD10 codes were collected. The data were analyzed by SPSS 18 software, using descriptive statistics, Chi-square, independent t-test, and one-way analysis of variance. The total number of investigated certificates in Tohid and Besat Hospitals was 743 and 763, respectively. Most of the death certificates, according to the principles of ICD-10, were related to the mean age of 29.68±2.81 years. Incorrect and blank codes in Besat Hospital was 69.7% and 1.3%, respectively, and.7% and 2.6% in Tohid Hospital, respectively. The most common mistakes in determining the cause of death were, based on ICD-10 principles, for pediatricians, neurosurgery, and the least common mistakes was related to forensic professionals. The accuracy of the causes of death recorded by physician based on ICD-10 principles was desirable in Tohid Hospital and was low in Besat Hospital, indicating a failure to properly determine the cause of death by physicians on death certificates in this hospital.

Growth of the elderly population has led to an increase in the prevalence of abuse against them, which is considered a major social health problem in today's communities. The aim of the present study was to examine the relationship between socio-demographic factors and the prevalence of abuse among the elderly population covered by health centers in Kashan.
Instruments and In this descriptive-analytical study in 2014, 500 elderly people over 60 years covered by health centers in Kashan were selected through multistage cluster sampling. The domestic elder abuse questionnaire was used to collect the data. Data were analyzed by SPSS 21, using Chi-square and logistic regression analysis. The mean age of the study population was 72.07±9.03 years. The prevalence of emotional neglect, neglect of care, and financial neglect, divest, experienced psychological abuse, financial abuse, physical abuse, and rejection was 6.8%, 8.29%, 2.35%, 6.37%, 45%, 2.41%, 22.45%, and 16.6%, respectively. A significant statistical relationship was observed between the abuse and age (p=0.001), number of children (p=0.001), marital status (p=0.011), the living conditions of elder with family (p=0.001), having disease (p=0.029), and having the ability to walk (p=0.001). Adults with a higher age, more children, without a spouse, living with a child, and having a history of illness and inability to walk are more exposed to abuse.

As one of the vital needs of the human community, the health of food and drink has always attracted the attention of legislators. Because unhealthy nutrition has adverse effects and consequences such as the spread of disease, physical and psychological disturbances will be addressed to the community. The aim of this study was to investigate the legal measures for the prevention and counteraction of crimes and violation of food and drink in Iran’s legal system. In this review study with library method, materials were collected by taking notes and they were analyzed, using descriptive-analytical method and logical deduction. To respond to what the crimes and violation of food stuff field are and what the measures of legislator are to confronte and prevent these crimes, primary legitimate criminal policy of Iran in food stuff and drink field and its dimensions, as well as important institutions for dealing with these crimes and violation were expressed. Then the measures that legislators in anticipation and prevention of these crimes and incidents have predicted, depending on the current rules, were investigated. Finally, these challenges and solutions in this field and the ways to egress have been mentioned.

Trafficking illicit drugs by body packers is a common problem in many countries. Trying to hide the packs by these people and lack of clear history in most cases makes diagnosis difficult. This study was an autopsy finding about a sudden death in a 37-year-old man suffering from cardiac arrest at the airport.
Patient & On December 1, 2017, a 37-year-old man at Imam Khomeini airport in Tehran, while intending travel abroad, suffered from cardiac arrest and sudden death. Due to death in public places and unknown cause of death, the body was referred to Forensic Organization. On the physical examination, no apparent signs of trauma were found. There was no abnormal observation in the examination of the brain, heart, throat, and larynx. The lungs were firm and congested. Mucous erosion was observed in the stomach and narrow intestine. In longitudinal incision of the colon, 13 white packets of 2 cm in length and 0.5 cm in width, were found containing methamphetamine, two of which were pierced and discharged into the body. In GC-mass and TLC toxicology tests, the presence of methamphetamine in urine, bile, and stomach contents was confirmed and acute toxicity of methamphetamine was determined as the cause. In cases of sudden unexpected death in young individuals, especially at airports and terminals, pierced packs in a body packer should be considered as the cause of death. Performing a complete autopsy to confirm the toxicity and determining the type of drug trafficking and rule out the other causes of death and homicidal matters is necessary.